Open and arthroscopic deepening trochleoplasty improves post-operative outcomes: A systematic review of the literature reveals lack of comparability between techniques.
Signe Høj, Johanne Kofoed Lundegaard, Lars Blønd, Peter Lavard, Anke Simone Rechter, Christian Dippmann, Kristoffer W Barfod
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Abstract
Purpose: Deepening trochleoplasty improves outcomes in patients with trochlear dysplasia. The aim of this systematic review was to present the outcomes after open thin-flap, open thick-flap and arthroscopic deepening trochleoplasty.
Methods: A systematic review was conducted using the PRISMA guidelines. Literature was searched in the PubMed, EMBASE and Cochrane databases on 16 December 2024. All studies from the inception of the databases to the date of the search were included in the search. Studies were included if they examined patients with patellar instability and trochlear dysplasia treated with either open or arthroscopic deepening trochleoplasty and reported pre- and post-operative outcomes. Two independent reviewers screened titles and abstracts, reviewed the full text and performed the quality assessment.
Results: A total of 32 studies, consisting of 1435 trochleoplasty cases in 1310 patients, were included. Of the included studies, 21 concerned open thin-flap trochleoplasty, 8 concerned open thick-flap trochleoplasty and 3 concerned arthroscopic trochleoplasty. The most used patient-reported outcome measures were the Kujala score, International Knee Documentation Committee score, visual analogue scale pain score, Lysholm Knee Score and Tegner Activity Scale; and the most reported radiological outcome measures were trochlear sulcus angle, trochlear bump, trochlear depth, tibial tubercle-trochlear groove distance, Caton-Deschamps index and patellar tilt. All three trochleoplasty techniques lead to improvements in post-operative outcome measures.
Conclusion: Deepening trochleoplasty improves post-operative outcome using both open thin-flap, open thick-flap and arthroscopic deepening technique. Comparison between the techniques is challenging due to low methodological quality of studies. Further research is needed to document treatment effect and improve patient outcome.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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